Recurrent Gouty Arthritis

Most people with gout have another attack within two years. This attack may affect many different joints. With recurrent gout, tophi can form. Tophi are chalky deposits of uric acid that commonly occur in the elbows and earlobes.

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. A sample of fluid from the affected joint will be taken. This fluid will be tested for uric acid crystals.

Other tests may include:

Blood and urine tests—to measure the level of uric acid in your blood and to assess kidney function

X-ray
—a test that uses radiation to take a picture of structures inside the body, especially bones; used to check for joint destruction

Treatment

Treatment depends on whether the gout is acute or recurrent.

Acute Gouty Arthritis

In general, the sooner treatment begins for an acute attack, the more effective it is. Treatment depends on:

Onset of symptoms

Number of joints affected

Previous responses to treatment

Overall health

General Measures

Putting a warm pad or an ice pack on the joint may ease the pain. Keeping the weight of clothes or bed covers off the joint can also help.

Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs), for example:

Indomethacin

Ibuprofen

Naproxen

Corticosteroids—used if NSAIDs are not effective or not recommended

A study found that people given corticosteroid plus acetaminophen had fewer adverse affects than those given NSAID plus
acetaminophen
.

Colchicine
—used to prevent gout attacks, but seldom used as a treatment for an acute attack
Note
: This drug has many adverse effects, so it is rarely used first.

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Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY.
Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.